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In the context of a positive Hoover's sign, functional weakness (or "conversion disorder") is much more likely than malingering or factitious disorder. [3] Strong hip muscles can make the test difficult to interpret. [4] Efforts have been made to use the theory behind the sign to report a quantitative result. [5]
Extension phenomena are positive if the great toe dorsiflexes (goes up) following the stimulus: . Babinski reflex: The plantar aspect of the foot is gently stimulated in a line starting a few centimeters distal to the heel and extended to a point just behind the toes, and then turned medially across the transverse arch.
Distraction tests: positive tests are rechecked when the patient's attention is distracted, such as a straight leg raise test; Regional disturbances: regional weakness or sensory changes which deviate from accepted neuroanatomy; Overreaction: subjective signs regarding the patient's demeanor and reaction to testing
However, there are two exceptions: firstly, the GSV collaterals (the veins that run parallel) drain the abdominal wall and have a flow from top to bottom so that, when an examiner tests the saphenofemoral junction, a false-positive diagnosis might be made; secondly, in the flow from the sole of the foot venous network, around 10% drains to the ...
Stabilize the pelvis and let the affected leg drop. A positive test is indicated if the leg does not adduct to the table. [1] Thomas test for tight hip flexors both performed by the provider holding the unaffected leg to the chest and leaving the affected leg on the table. If the affected leg cannot lie flat on the table it is a positive test. [1]
After many examples of false-positive Homans' signs were reported, Homans redefined it in 1944, stating that "discomfort need have no part in the reaction", and that increased resistance, involuntary flexure of the knee or pain in the calf upon forced dorsiflexion should be considered positive responses. [1] [2] [3] [needs update]
Neurogenic claudication commonly describes pain, weakness, fatigue, tingling, heaviness and paresthesias that extend into the lower extremities. [9] These symptoms may involve only one leg, but they usually involve both. Leg pain is usually more significant than back pain in individuals who have both. [12]
The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).